口腔医学研究

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (10): 884-888.DOI: 10.13701/j.cnki.kqyxyj.2026.10.010

• 口腔肿瘤学研究 • 上一篇    下一篇

颌骨牙源性透明细胞癌的临床及影像学特征分析

文珊辉1, 夏舒2, 高安天1, 冯永静1, 王铁梅1*   

  1. 1.南京大学医学院附属口腔医院口腔颌面医学影像科,南京市口腔医院,南京大学口腔医学研究所 江苏 南京 210008;
    2.南京大学医学院附属口腔医院口腔病理科,南京市口腔医院,南京大学口腔医学研究所 江苏 南京 210008
  • 收稿日期:2026-01-04 发布日期:2026-10-23
  • 通讯作者: * 王铁梅,E-mail:tiemei106@263.net
  • 作者简介:文珊辉(1989~ ),男,江西抚州人,硕士,副主任医师,研究方向:口腔颌面医学影像。
  • 基金资助:
    江苏省临床重点专科(编号:CZ0008)

Analysis on Clinical and Imaging Features of Clear Cell Odontogenic Carcinoma of the Jaw

WEN Shanhui1, XIA Shu2, GAO Antian1, FENG Yongjing1, WANG Tiemei1*   

  1. 1. Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China;
    2. Department of Oral Pathology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210008, China
  • Received:2026-01-04 Published:2026-10-23

PDF (PC)

12

摘要： 目的: 分析总结颌骨牙源性透明细胞癌的临床及影像学特征,以期提高对颌骨牙源性透明细胞癌这一罕见疾病影像鉴别诊断和认识。方法: 回顾性分析经病理检查证实的6例颌骨牙源性透明细胞癌患者临床及CT影像学特征。结果: 6例颌骨牙源性透明细胞癌患者,平均年龄59.6岁,男女比例为2∶1,发病时长2个月~5年不等,其发病部位以颌骨后部多见。牙源性透明细胞癌特征性影像表现为具有颌骨膨隆性(下颌骨较显著,上颌骨较轻微)的骨质破坏,边缘局部侵袭性征象,并可形成软组织肿块;其中下颌骨以膨胀性骨质破坏为主,上颌骨则表现为溶蚀样骨质破坏。病理特征:3例行荧光原位杂交检测,其中2例示尤文肉瘤断裂区域1(Ewing sarcoma breakpoint region 1,EWSR1)基因重排,1例示EWSR1/激活转录因子1(activating transcription factor 1,ATF1)基因融合。结论: 下颌骨牙源性透明细胞癌以膨胀性骨质破坏多见,影像显示具有局部侵袭性,临床及影像需要与其他具有局部侵袭性的病变相鉴别;上颌骨牙源性透明细胞癌多表现为溶蚀样骨质破坏并形成软组织肿块,影像上基本呈现低度恶性征象,临床及影像需要与其它颌骨恶性肿瘤相鉴别。

关键词: 颌骨, 牙源性透明细胞癌, 临床表现, 影像特征

Abstract: Objective: To investigate the clinicoradiological features of clear cell odontogenic carcinoma (CCOC) in the jaw, summarize its imaging characteristics, and improve the differential diagnosis and understanding of this rare disease. Methods: A retrospective analysis was performed on the clinical and CT imaging features of six cases of CCOC confirmed by histopathological examination. Results: The six CCOC patients had a mean age of 59.6 years and a male-to-female ratio of 2∶1, with disease duration ranging from 2 months to 5 years. Lesions predominantly occurred in the posterior jaw. Characteristic imaging findings included bone destruction with jaw expansion (more pronounced in the mandible and milder in the maxilla), locally aggressive margins, and soft tissue mass formation. Mandibular lesions primarily presented as expansive bone destruction, whereas maxillary lesions exhibited moth-eaten or erosive bone destruction. Fluorescence in situ hybridization was performed in three cases, revealing Ewing sarcoma breakpoint region (EWSR1) gene rearrangement in two cases and EWSR1/Activating transcription factor 1 (ATF1) gene fusion in one case. Conclusion: Mandibular CCOC typically presents as expansive bone destruction with locally aggressive imaging features, requiring differentiation from other locally aggressive lesions. Maxillary CCOC shows erosive bone destruction with soft tissue mass formation, exhibiting imaging signs consistent with low-grade malignancy, and must be distinguished from other malignant tumors of the jaw.

Key words: jaw, clear cell odontogenic carcinoma, clinical manifestation, imaging features